Lung Analysis and Reporting System

Abstract

The present invention is entitled "Lung Analysis and Reporting System". The present disclosure provides a system and method for analyzing scan data of a lung and presenting a lung candidate report. The lung candidate report includes a determination that visually represents whether a lung lobe is a suitable candidate for a bronchoscopic lung volume reduction procedure. The lung candidate report includes emphysema values ​​and fissure integrity determined from the scan data.

Description

Background Art

[0001] Analyzing a patient's high-resolution computed tomography (HRCT) information and quantitative computed tomography (QCT) findings is critical for successful patient outcomes. To ensure the success of bronchoscopic lung volume reduction (BLVR) surgery, reliable critical measurements of emphysema severity, fissure integrity, and heterogeneity are required to allow physicians to quickly and confidently identify target lobes and potential candidates for treatment. Summary of the invention

[0002] The present disclosure provides improved systems and methods for providing lung candidate information to healthcare professionals.

[0003] The present disclosure provides an exemplary system having a processing device that receives three-dimensional image data of at least a portion of a human lung, the three-dimensional image data including volume data (i.e., voxels). The processing device depicts lung lobes and lung fissures based on voxels, and for each of the voxels in the depicted lung lobes, generates an emphysema score for each of the lung lobes based on a predefined threshold of a radiation intensity value or a threshold range of a radiation intensity value. The processing device generates a fissure integrity score for each of the lung fissures based on the voxels, generates a heterogeneity score for at least two lobes based on the emphysema score of the target lobe and the emphysema score of the lobe adjacent to the target lobe, and generates a report including an emphysema score, a fissure integrity score, and a heterogeneity score. The system includes an output device that communicates signals with the processing device. The output device outputs a report.

[0004] In one aspect of the present disclosure, the report includes a visual representation of the emphysema level based on a generated emphysema score, a visual representation of fissure integrity based on a generated fissure integrity score, and a visual representation of lobe candidates. The visual representation of the emphysema level includes a visual representation of each of the lobes, wherein the emphysema level is visually represented by at least one of a specific color or pattern of the corresponding lobe visual representation. The visual representation of fissure integrity includes a visual representation of each of the delineated fissures, wherein the delineated fissures are visually represented by at least one of a specific color or pattern based on the fissure integrity score.

[0005] In another aspect of the present disclosure, a visual representation of a lobe candidate includes a lobe candidate icon that is visually associated with a corresponding lobe visual representation. The lobe candidate icon includes an emphysema score and a heterogeneity score for the associated lobe and a fissure completeness score for a fissure adjacent to the associated lobe. The lobe candidate icon includes a visual indication that a predefined inclusion criteria is met. The visual indication that the predefined inclusion criteria is met includes representing at least a portion of the lobe candidate icon in at least one of a unique color or pattern.

[0006] Other features, advantages, and areas of applicability will become apparent from the description provided herein.It should be understood that the detailed description and specific examples are intended for illustrative purposes only and are not intended to limit the scope of the present disclosure. BRIEF DESCRIPTION OF THE DRAWINGS

[0007] The drawings described herein are for illustrative purposes only and are not intended to limit the scope of the present disclosure in any way. The components in the drawings are not necessarily drawn to scale, but emphasis is placed on illustrating the principles of the present invention. In the drawings:

[0008] Figure 1 is a block diagram of an exemplary system formed according to an embodiment of the present invention;

[0009] Figure 2 is at least Figure 1 A flowchart of an exemplary process performed by the system; and

[0010] Figure 3 is based on Figure 2 The process shown is Figure 1 An image of a report generated by the system. DETAILED DESCRIPTION

[0011] The following description is merely exemplary in nature and is not intended to limit the present disclosure, application, or uses. The following description explains various embodiments of an apparatus and method for analyzing and providing a comprehensive report for determining a candidate lung lobe for a pending bronchoscopic lung volume reduction (BLVR) procedure by way of illustration and not limitation.

[0012] One embodiment describes a process of automating, displaying, interacting with, and characterizing various aspects of the lung. When a human lung is imaged in vivo using an imaging acquisition device, the image can be reconstructed and evaluated to show normal and disease states. Due to the various subtypes of the disease and the various descriptions (phenotypes) of the disease entity, evaluating the lobular regions of the lung and separating their fissures is of great importance for accurately characterizing the disease and predicting the response to BLVR treatment.

[0013] The present disclosure includes systems and methods that provide visualization of lung lobes, fissure integrity, and values ​​associated with the extent of emphysema in an automated manner to enable clinical decision making.

[0014] The left and right lungs are each divided into multiple lobes by deep fissures, which are interlobar fissures, referred to herein as fissures. The outer surface of the lung is lined by a pleura including an inner layer, which is the pulmonary pleura that is immersed in the fissures to surround the lobes. Therefore, the fissure is the junction between the lobes of the lung and is defined by the outermost surfaces of the lobes and the pulmonary pleura at the location where the lobes are adjacent to each other. Therefore, although the fissure itself is actually a junction between adjacent lobes, it is a very thin layer of lobe junction detectable on a volume image and is therefore understood as a fissure. The right lung includes three lobes (upper lobe, middle lobe and lower lobe), which are separated by two fissures, which are called oblique fissures and horizontal fissures. The left lung includes two lobes (upper lobe and lower lobe) with a fissure between them, namely the oblique fissure.

[0015] The edges of the leaves and the pleura lining these leaves define the fissures and separate these leaves so that the ventilation of each leaf is separated from the ventilation of the adjacent adjacent leaves. In addition, the pleura usually forms a smooth surface, thereby allowing the adjacent leaves to slide relative to each other during inspiration and expiration. However, in certain conditions, the pleura may become thickened or adherent. In addition, the adjacent leaves may adhere to each other, and the pleura and lung edges that usually define the fissures may disappear. The fissures are described by the level of integrity, and below a certain level, air can flow between the leaves. Various embodiments described herein use volumetric radiographic images to identify fissure integrity and visually present them in 2D images.

[0016] Figure 1 An exemplary lung visualization system 10 is shown, which may include a processor, such as a processor 40 in a computer, and may also include an output device 42, such as a visual display (monitor or screen) or a printing device. The system 10 may also include instructions included in software (computer-readable media) that are stored in a memory of the system and are operable on the processor 40. The software may include instructions for the processor 40 to perform the various steps and methods described herein, including instructions to receive patient data including volumetric imaging data from a data source 20 that may be connected to the processor 40 via a public data network and / or a private data network 30, instructions to analyze the data to characterize the lungs, and instructions to generate images resulting from the analysis of the imaging data. The generated images may be transmitted to a client computing device via the data network 30, or may be output in physical form and delivered to the client.

[0017] Examples of these embodiments may be implemented using a combination of hardware, firmware, and / or software. For example, in many cases, some or all of the functions provided by the examples may be implemented in executable software instructions that can be carried on a programmable computer processor. Likewise, some examples of the present invention include a computer-readable storage device having such executable software instructions stored thereon. In a specific example, the system processor itself may include instructions for performing one or more tasks. The system processing power is not limited to any specific configuration, and those skilled in the art will appreciate that the teachings provided herein may be implemented in a variety of different ways.

[0018] Figure 2 A flow chart of a lung characterization and visualization method 60 is shown that may be implemented, for example, using software as part of the system 10. At step 64, a volumetric radiographic image or imaging data of the patient is transmitted from the data source 20 to the processing device 40. The volumetric radiographic image or imaging data may be a computed tomography (CT) scan, a magnetic resonance imaging (MRI) scan, and / or a positron emission tomography (PET) scan, from which a series of two-dimensional planar images (referred to herein as two-dimensional volumetric images or two-dimensional images) may be generated in multiple planes.

[0019] At step 66, the received image data is used to segment the lung, airway and / or blood vessel. The method for segmenting the lung, airway and blood vessel according to the volume image or imaging data can be those described in various research reports (e.g., Strange C, Herth, FJ, Kovitz, KL, McLennan, G, Ernst, A, Goldin J et al., "Design of the EndobronchialValve for Emphysema Palliation Trial (VENT): a nonsurgical method of lung volume reduction", BMC Pulm Med., July 3, 2007, 7:10). The segmentation of the lung, airway and blood vessel causes the lung tissue, airway and blood vessel to be identified as being different from surrounding tissue, and causes the lung, airway and blood vessel to be separated into smaller different parts that can be identified separately according to the standard lung anatomical structure. Then describe the lung lobe according to the separated data.

[0020] At step 68, an emphysema score is generated for each lobe based on the Hounsfield Unit (i.e., radiometric intensity (HU)) value of each voxel in the lobar data of the target lobe. In one embodiment, the emphysema score is identified as a percentage of emphysema in the lobe. The percentage is calculated by determining what percentage of lobe voxels have a Hounsfield Unit value that is less than a threshold amount (e.g., -920 HU) or within a range of Hounsfield Unit values.

[0021] Next, at step 70, a fissure integrity value is generated for each of the three fissures based on the analysis of the imaging data. An exemplary method for calculating a fissure integrity value is described in Brown, MS, Ochs, R, Abtin, F, Ordookhani, A, Brown, M, Kim, H, Shaw, G, Chong, D, Goldin, J., "Automated Quantitative Assessment of Lung Fissure Integrity on CT"; Proceedings of the First International Workshop on Pulmonary Image Analysis, New York, USA, 2008: pp. 93-102.

[0022] Then, at step 72 , a heterogeneity score is generated for each lobe based on the difference between the emphysema score of the target lobe and the emphysema scores of lobes adjacent to the target lobe.

[0023] Next, at step 74, a report is generated that includes an image including BLVR candidate icons for at least two lobes, a fissure integrity indicator, and an emphysema level visual indicator.

[0024] Then, at step 76, the healthcare provider performs a BLVR procedure based on a review of the generated report, i.e., placement of one or more umbrella valves (IBVs) in the lobes of the lung. An exemplary IBV is composed of Produced by IBV valve system.

[0025] Figure 3 An exemplary report 80 generated by the processing device 40 is shown. Figure 2 The report 80 may be generated in any of a number of different formats and may be delivered to the entity that originally requested the report (e.g., a health care professional treating a patient associated with the analyzed image data) in any number of different ways. The report 80 includes a lung display area 82 that includes an image of a lung lobe 84. The previously calculated emphysema score is graphically represented on the image of the lobe 84 by a particular pattern or color based on where the emphysema score falls within a predefined scale (see the emphysema score scale to the left of the lung display area 82).

[0026] In the lung display area 82, the fissure lines 86 are shown between their corresponding lobes. The fissure lines 86 are presented with a specific line pattern and / or color based on the previously calculated fissure integrity score and fissure integrity ratio (see fissure integrity ratio in the emphysema score ratio shown below).

[0027] In the lung display area 82, BLVR candidate icons 90 are shown next to or overlapping the associated lung lobes. In this example, icons 90 are shown only for the right upper lobe, right lower lobe, left upper lobe, and left lower lobe. However, the calculated scores for all lobes will be shown in the table at the bottom of the report 80. The BLVR candidate icons 90 include calculated scores for emphysema, fissure integrity, and heterogeneity. The background color or pattern of each score in the icon 90 indicates whether the predefined inclusion criteria (i.e., thresholds) for each of these scores are met or not met. The icons 90 provide a visual tool that enables the healthcare professional to determine which lobes are good candidates for BLVR surgery. Figure 3 In the example of , the upper left lobe is the only lobe where all three scores satisfy the associated predefined criteria (ie, thresholds). These criteria are determined based on experience gained from multiple clinical trials.

[0028] The description of the present invention is merely exemplary in nature, and variations that do not depart from the gist of the present invention are intended to be included within the scope of the present invention. Such variations should not be regarded as departing from the spirit and scope of the present invention.

[0029] Implementation

[0030] A. A method comprising: receiving three-dimensional image data of at least a portion of a human lung, the three-dimensional image data comprising voxels; delineating lung lobes and lung fissures based on the voxels; for each of the voxels in the delineated lung lobes, generating an emphysema score for each of the lung lobes based on a predefined threshold of a radiation intensity value or a threshold range of radiation intensity values; generating a fissure integrity score for each of the lung fissures based on the voxels; generating a heterogeneity score for at least two lobes based on the emphysema score of the target lobe and the emphysema scores of lobes adjacent to the target lobe; generating a report comprising an emphysema score, a fissure integrity score, and a heterogeneity score; and outputting the report.

[0031] B. The method of A, wherein the report comprises: a visual representation of the emphysema level based on the generated emphysema score; a visual representation of the fissure integrity based on the generated fissure integrity score; and a visual representation of the lobe candidates.

[0032] C. The method of B, wherein the visual representation of the emphysema level comprises a visual representation of each of the lung lobes, wherein the emphysema level is visually represented by at least one of a particular color or a pattern of the corresponding lung lobe visual representation.

[0033] D. The method of B or C, wherein the visual representation of crack integrity comprises a visual representation of each of the delineated cracks, wherein the delineated cracks are visually represented by at least one of a specific color or pattern based on the crack integrity score.

[0034] E. A method according to any one of B to D, wherein the visual representation of the lobe candidate includes a lobe candidate icon that is visually associated with the corresponding lobe visual representation.

[0035] F. The method according to E, wherein the lobe candidate icon comprises an emphysema score and a heterogeneity score of the associated lobe and a fissure completeness score of a fissure adjacent to the associated lobe.

[0036] G. The method of E or F, wherein the lobe candidate icons include a visual indication that they meet predefined inclusion criteria.

[0037] H. The method of G, wherein the visual indication that the predefined inclusion criteria are met comprises representing at least a portion of the lung lobe candidate icon in at least one of a unique color or pattern.

[0038] I. The method according to any one of A to H, wherein the radioactivity value is expressed in Hounsfield units.

[0039] J. A system comprising: a processing device configured to: receive three-dimensional image data of at least a portion of a human lung, the three-dimensional image data comprising voxels; delineate lobes and fissures according to the voxels; for each of the voxels in the delineated lobes, generate an emphysema score for each of the lobes based on a predefined threshold of the radiation intensity value or a threshold range of the radiation intensity value; generate a fissure integrity score for each of the fissures based on the voxels; generate a heterogeneity score for at least two lobes based on the emphysema score of the target lobe and the emphysema scores of lobes adjacent to the target lobe; and generate a report comprising the emphysema score, the fissure integrity score, and the heterogeneity score; and an output device in signal communication with the processing device, the output device configured to output the report.

[0040] K. The system of J, wherein the report comprises: a visual representation of the emphysema level based on the generated emphysema score; a visual representation of the fissure integrity based on the generated fissure integrity score; and a visual representation of the lobe candidates.

[0041] L. A system according to K, wherein the visual representation of the emphysema level comprises a visual representation of each of the lung lobes, wherein the emphysema level is visually represented by at least one of a specific color or a pattern of the corresponding lung lobe visual representation.

[0042] M. A system according to K or L, wherein the visual representation of crack integrity comprises a visual representation of each of the delineated cracks, wherein the delineated cracks are visually represented by at least one of a specific color or pattern based on the crack integrity score.

[0043] N. A system according to any one of K to M, wherein the visual representation of the lobe candidates includes a lobe candidate icon that is visually associated with a corresponding one of the lobe visual representations.

[0044] O. The system of N, wherein the lobe candidate icon comprises an emphysema score and a heterogeneity score of the associated lobe and a fissure completeness score of a fissure adjacent to the associated lobe.

[0045] P. A method according to N or O, wherein the lobe candidate icons include a visual indication that the lobe candidate icons meet predefined inclusion criteria.

[0046] Q. A system according to P, wherein the visual indication that the predefined inclusion criteria are met comprises representing at least a portion of the lung lobe candidate icon in at least one of a unique color or pattern.

[0047] R. A system according to any one of J to Q, wherein the radioactivity values ​​are expressed in Hounsfield Units.

[0048] S. A non-transitory computer-readable recording medium having an executable program stored thereon, the program causing a processor to: receive three-dimensional image data of at least a portion of a human lung, the three-dimensional image data comprising voxels; delineate lobes and fissures according to the voxels; for each of the voxels in the delineated lobes, generate an emphysema score for each of the lobes based on a predefined threshold of a radiation intensity value or a threshold range of a radiation intensity value; generate a fissure integrity score for each of the fissures based on the voxels; generate a heterogeneity score for at least two lobes based on the emphysema score of the target lobe and the emphysema scores of lobes adjacent to the target lobe; generate a report comprising an emphysema score, a fissure integrity score, and a heterogeneity score; and output the report to an output device.

[0049] T. The non-transitory computer-readable recording medium of claim 19, wherein the report comprises: a visual representation of the emphysema level based on the generated emphysema score; a visual representation of the fissure integrity based on the generated fissure integrity score; and a visual representation of the lobe candidates.

[0050] U. A system comprising: a processing device configured to: receive an emphysema score for each lung lobe previously depicted based on three-dimensional image data of at least a portion of a human lung; receive a fissure integrity score for each of the lung fissures previously depicted based on the three-dimensional image data; receive heterogeneity scores for at least two lobes; and generate a report including the emphysema score, the fissure integrity score, and the heterogeneity score; and an output device in signal communication with the processing device, the output device configured to output the report.

[0051] V. The system of U, wherein the report comprises: a visual representation of the emphysema level based on the generated emphysema score; a visual representation of the fissure integrity based on the generated fissure integrity score; and a visual representation of the lobe candidates.

[0052] W. A system according to V, wherein the visual representation of the emphysema level includes a visual representation of each of the lung lobes, wherein the emphysema level is visually represented by at least one of a specific color or a pattern of the corresponding lung lobe visual representation.

[0053] X. The system of V or W, wherein the visual representation of crack integrity comprises a visual representation of each of the delineated cracks, wherein the delineated cracks are visually represented by at least one of a specific color or pattern based on the crack integrity score.

[0054] Y. A system according to any one of V to X, wherein the visual representation of the lobe candidates includes a lobe candidate icon that is visually associated with a corresponding one of the lobe visual representations.

[0055] Z. The system according to Y, wherein the lobe candidate icon comprises an emphysema score and a heterogeneity score of an associated lobe and a fissure completeness score of a fissure adjacent to the associated lobe.

[0056] AA. A method according to Y or Z, wherein the lobe candidate icons include a visual indication that they meet predefined inclusion criteria.

[0057] AB. The system of AA, wherein the visual indication that the predefined inclusion criteria are met comprises representing at least a portion of the lobe candidate icon in at least one of a unique color or pattern.

[0058] AC. A system according to any one of U to AB, wherein the radiation intensity values ​​are expressed in Hounsfield units.

[0059] Although the preferred embodiments of the present invention have been described so far, the present invention is not limited to these embodiments. Additions, omissions, substitutions, and other modifications may be made without departing from the spirit or scope of the present invention.

Claims

1. A method for providing lung candidate information, the method comprising: receiving three-dimensional image data of at least a portion of a lung of a person, the three-dimensional image data comprising voxels; delineating lung lobes and lung fissures according to the voxels; generating, for each of the voxels in the delineated lung lobes, an emphysema score for each of the lung lobes based on a predefined threshold of radiation intensity values ​​or a threshold range of radiation intensity values; scoring each of the fissures for completeness based on the voxels; generating a heterogeneity score for at least two lobes based on the emphysema score of the target lobe and the emphysema score of a lobe adjacent to the target lobe; generating a report including the emphysema score, the fissure integrity score, and the heterogeneity score; as well as outputting the report; wherein the report comprises: a visual representation of the level of emphysema based on the generated emphysema score; a visual representation of fissure integrity based on the generated fissure integrity score; and a visual representation of lobe candidates; wherein the visual representation of the emphysema level includes a visual representation of each of the lung lobes, wherein the emphysema level is visually represented by at least one of a particular color or pattern of the corresponding lung lobe visual representation; wherein the visual representation of the cleft integrity comprises a visual representation of each of the delineated clefts, wherein the delineated clefts are visually represented by at least one of a particular color or pattern based on the cleft integrity score; wherein the visual representation of the lobe candidates comprises a plurality of lobe candidate icons, the plurality of lobe candidate icons being visually individually associated with an individual one of the plurality of visual representations, wherein the individual one of the lobe candidate icons comprises a visual indication that the emphysema score, the fissure integrity score, and the heterogeneity score meet predefined inclusion criteria, the visual indication that the predefined inclusion criteria are met comprises representing at least a portion of the lobe candidate icon in at least one of a unique color or pattern; The lung lobe candidate icon includes the emphysema score and the heterogeneity score of the associated lung lobe and the fissure completeness score of the fissure adjacent to the associated lung lobe.

2. The method of claim 1, wherein the radioactivity value is expressed in Hounsfield units.

3. The method of claim 1, further comprising performing a bronchoscopic lung volume reduction surgery procedure on the human based on the output report.

4. A system for providing lung candidate information, the system comprising: A processing device, the processing device being configured to: receiving three-dimensional image data of at least a portion of a lung of a person, the three-dimensional image data comprising voxels; delineating lung lobes and lung fissures according to the voxels; generating, for each of the voxels in the delineated lung lobes, an emphysema score for each of the lung lobes based on a predefined threshold of radiation intensity values ​​or a threshold range of radiation intensity values; scoring each of the fissures for completeness based on the voxels; generating a heterogeneity score for at least two lobes based on the emphysema score of the target lobe and the emphysema scores of lobes adjacent to the target lobe; and generating a report including the emphysema score, the fissure integrity score, and the heterogeneity score; and an output device in signal communication with the processing device, the output device being configured to output the report; wherein the report comprises: a visual representation of the level of emphysema based on the generated emphysema score; a visual representation of fissure integrity based on the generated fissure integrity score; and a visual representation of lobe candidates; wherein the visual representation of the emphysema level includes a visual representation of each of the lung lobes, wherein the emphysema level is visually represented by at least one of a particular color or pattern of the corresponding lung lobe visual representation; wherein the visual representation of the cleft integrity comprises a visual representation of each of the delineated clefts, wherein the delineated clefts are visually represented by at least one of a particular color or pattern based on the cleft integrity score; wherein the visual representation of the lobe candidates comprises a plurality of lobe candidate icons, the plurality of lobe candidate icons being visually individually associated with an individual one of the plurality of visual representations, wherein the individual one of the lobe candidate icons comprises a visual indication that the emphysema score, the fissure integrity score, and the heterogeneity score meet predefined inclusion criteria, the visual indication that the predefined inclusion criteria are met comprises representing at least a portion of the lobe candidate icon in at least one of a unique color or pattern; The lung lobe candidate icon includes the emphysema score and the heterogeneity score of the associated lung lobe and the fissure completeness score of the fissure adjacent to the associated lung lobe. The system of claim 4 , wherein the radiation intensity value is expressed in Hounsfield units.

6. A non-transitory computer-readable recording medium having stored thereon an executable program, the program causing a processor to: receiving three-dimensional image data of at least a portion of a lung of a person, the three-dimensional image data comprising voxels; delineating lung lobes and lung fissures according to the voxels; generating, for each of the voxels in the delineated lung lobes, an emphysema score for each of the lung lobes based on a predefined threshold of radiation intensity values ​​or a threshold range of radiation intensity values; scoring each of the fissures for completeness based on the voxels; generating a heterogeneity score for at least two lobes based on the emphysema score of the target lobe and the emphysema score of a lobe adjacent to the target lobe; generating a report including the emphysema score, the fissure integrity score, and the heterogeneity score; and outputting the report to an output device, wherein the report comprises: a visual representation of the level of emphysema based on the generated emphysema score; a visual representation of the fissure integrity based on the generated fissure integrity score; and Visual representation of lobe candidates; wherein the visual representation of the emphysema level includes a visual representation of each of the lung lobes, wherein the emphysema level is visually represented by at least one of a particular color or pattern of the corresponding lung lobe visual representation; wherein the visual representation of the cleft integrity comprises a visual representation of each of the delineated clefts, wherein the delineated clefts are visually represented by at least one of a particular color or pattern based on the cleft integrity score; wherein the visual representation of the lobe candidates comprises a plurality of lobe candidate icons, the plurality of lobe candidate icons being visually individually associated with an individual one of the plurality of visual representations, wherein the individual one of the lobe candidate icons comprises a visual indication that the emphysema score, the fissure integrity score, and the heterogeneity score meet predefined inclusion criteria, the visual indication that the predefined inclusion criteria are met comprises representing at least a portion of the lobe candidate icon in at least one of a unique color or pattern; The lung lobe candidate icon includes the emphysema score and the heterogeneity score of the associated lung lobe and the fissure completeness score of the fissure adjacent to the associated lung lobe.

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